In the fourth of this 6-part series, Gaetane C. Michaud, MD, chief of interventional pulmonary medicine at New York University (NYU) Langone Medical Center and associate professor of medicine, speaks with Pulmonology Advisor about the various surgical team members who are involved in airway stenting and how they approach each procedure.
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We are lucky because we work with some really fabulous people. We have daily conversations with anesthesia, particularly with high-acuity cases. We sit down and have a discussion about what we are going to do, what is our anesthetic plan, and what is our fail-safe. We always have a backup plan to make sure that we know when it’s time to get out and what we are going to do. We also work closely with thoracic surgery; in fact, every person on my team is cross-appointed to cardiothoracic surgery, so we always have backup. If we are going into a case that is a little bit more complex, where we are also questioning the safety, we will always let them know in advance and make sure that somebody is around. It is funny because we have never used them, but we have let them know about a number of cases. Sometimes it just feels nice to have some somebody standing beside you.
We did an incredibly difficult case that involved a patient who had residual suture material from a surgery performed at another institution many years earlier, which happened to be sutured to the pulmonary artery. So, we removed that suture material, took it all out of the airway, and relieved the obstruction, but I also had a thoracic surgical team and a vascular team on standby; we made sure that we had all of our bases covered before we even walked in that operating room.
We also have a good relationship with our ear, nose, and throat surgeons. We share equipment with them and have daily conversations. In fact, our anesthesia and nursing teams are all ear, nose, and throat and pediatric people, so we have people trained in more difficult airways who work with us on a daily basis in the operating room.
Click here to view part 5.